| Objective: Dapagliflozin is effective in the treatment of heart failure with reduced ejection fraction.However,there is still no evidence whether there is a difference in the efficacy of dapagliflozin in heart failure patients with decreased ejection fraction due to different etiology and pathophysiological basis,such as dilated cardiomyopathy and ischemic cardiomyopathy.Therefore,this study observed and compared dapagliflozin in the treatment of ischemic cardiomyopathy with decreased ejection fraction and heart failure with dilated cardiomyopathy The effect of exhaustion and the difference between them provide reference for individualized treatment of patients with heart failure.Methods: Outpatient and inpatients with ICM and DCM heart failure diagnosed with decreased ejection fraction in the First Affiliated Hospital of Wannan Medical College from March 2021 to July 2022 were collected.Drug use of all patients was retrospectively analyzed.According to drug use,patients were divided into dapagliflozin group(n=60)and standard treatment group(n=67)In addition to the standard treatment,the standard treatment group was the patients receiving the standard treatment of heart failure(ARNI,B blocker,MRA).The included patients meeting the criteria were followed up.NYHA cardiac function grade,plasma B type natriuretic peptide,left ventricular ejection fraction,left ventricular end-diastolic diameter,Kansas City after 3 months were compared the efficacy of ICM and DCM patients in dapagliflozin group was further compared according to the different etiology,and adverse events(including cardiovascular death,re-hospitalization due to heart failure and adverse drug reactions)occurred during follow-up were collected.Results: 1.A total of 18 cases were lost to follow-up due to various reasons in the two groups,including 13 cases in the standard treatment group and 5 cases in the dapagliflozin group.In the standard treatment group,5 patients were readmitted to hospital due to heart failure,and 1 patient died of cardiovascular causes.In the dapagliflozin group,4 patients were readmitted to hospital due to heart failure,including 2 patients with DCM and 2patients with ICM,and no cardiovascular death occurred.There were no significant differences in the incidence of cardiovascular death and heart failure readmission between dapagliflozin group and standard treatment group(P>0.05).No drug-related adverse reactions occurred.2.The overall effective rate of dapagliflozin group was 51%,and that of standard treatment group was 33.3%,with no significant difference between the two groups(P>0.05).3.NYHA cardiac function grading,LVEF,BNP,LVEDD and KCCQ scores in dapagliflozin group were significantly improved,with statistical significance(P<0.05);NYHA cardiac function grade and LVEF were significantly improved in standard treatment group(P<0.05),but BNP,LVEDD and KCCQ scores were not significantly improved compared with those before treatment(P>0.05).Patients in the standard he improvement of LVEF and NYHA cardiac function grades in dapagliflozin group was better than that in standard treatment group(P<0.05).4.The indexes of ICM and DCM patients in dapagliflozin group before and after treatment were compared,and there were no significant differences in treatment response rate and incidence of cardiovascular adverse events between ICM and DCM groups(P>0.05).NYHA cardiac function grading,LVEF and BNP were significantly improved in ICM group(P<0.05),while NYHA cardiac function grading,LVEF,BNP,LVEDD and KCCQ scores were significantly improved in DCM group(P<0.05).There were no significant differences in NYHA cardiac function grade,LVEF and BNP improvement between the two groups(P>0.05).Conclusion: 1.Dapagliflozin can further improve cardiac structure and functional indicators,improve quality of life,and improve prognosis in patients with DCM and ICM heart failure with reduced ejection fraction.2.Dapagliflozin has better effect on improving ventricular remodeling and improving quality of life in DCM patients. |
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